针灸背俞穴配合刺络疗法治疗肝郁脾虚型慢性疲劳综合征的临床研究

【作者】 杜鹃；

【导师】 刘红；

【作者基本信息】 长春中医药大学 ， 针灸推拿学， 2010， 硕士

【摘要】 目的:观察针灸背俞穴配合刺络疗法治疗肝郁脾虚型慢性疲劳综合征的临床疗效。方法:将临床60例符合纳入标准的病例,盲法随机分成两组进行临床观察。治疗组主穴:①肝俞、②脾俞、③肾俞、④百会。配穴:太冲、关元、三阴交、足三里。刺络法:耳尖、大敦,双侧穴位交替点刺。随证加减:风热未清:加曲池、合谷;脾虚湿困,痰浊内阻:加丰隆,兼痰热者加内庭;心血不足:加神门,兼心阴虚者加阴郄;肾气不足:加太溪、气海。操作:患者仰卧位,穴位处常规消毒,主穴位刺法:用30号毫针针刺,肝俞、太冲用泻法,脾俞应用补法,得气后留针30-40min,每日1次,10次为1个疗程。配穴刺法:用30号毫针针刺,常规针刺,每日1次。足三里穴直刺刺入1.0-1.5寸,快速捻转行针,以补法为主,以局部酸胀、麻木感向下肢放散针感为佳,足三里穴留针期间施温针灸,每壮艾柱燃烧10-15min,连续灸三壮。耳尖、大敦,以统一型号的采血针点刺,出血量以每穴10-20滴为度,隔日1次。5次为1个疗程。对照组:国家准字号药品逍遥丸,口服每次一丸(9克),一日2次。治疗时间均为十天一疗程,不超过三个疗程(三十天),试验期间原则上停用影响临床疗效的相关药物。治疗前后采用《中药新药临床指导原则》制定的肝郁脾虚症状分级量化表,疲劳量表-14(FS-14)、疲劳自评量表(FAI)及焦虑自评量表(SAS)、抑郁自评量表(SDS)进行评价对两组患者进行积分的对比,并且进行两组间比较。结果:背俞穴配合刺络疗法治疗组总体疗效明显优于药物对照组。治疗组临床总有效率为93.3%,对照组总有效率为86.7%,经秩和检验,两组疗效具有显著性差异(P﹤0.01)。结论:针灸背俞穴配合刺络疗法治疗肝郁脾虚型慢性疲劳综合征疗效显著。更多还原

【Abstract】 Objective:to observe the clinical effect on Chronic fatigue syndrome of liver depression and spleen deficiency by using acupuncture and moxibustion Beishu acupoint and pricking bloodletting therapy.Method:Sixty cases of clinical cases in line with the inclusion meet a criterion, were randomly divided into two groups of blind clinical observation. treatment group master acupuncture point :①Ganshu,②Pishu,③Shenshu,④Baihui.secondary acupuncture point:Taichong , Guanyuan , Sanyinjiao ,Zusanli.Pricking bloodletting therapy:Erjian,Dadun. Pricking alternately two acupoint.Addition and subtraction with the evidence:hot wind outstanding:add Quchi,Hegu. spleen wet and hard-pressed, phlegm resistance: add Fenglong, who with heat add Neiting;Insufficient Heartblood: add Shenmen,and those with heart yin deficiency exchange Yinxi for Shenmen;kidney shortage: add Taixi,Qihai. Operation:The patient in supine position,acupoint of conventional disinfection,the methods of master acupuncture point : acupuncture with 30 size acicula, Ganshu、Taichong with draining methods and Pishu with supplementation methods,retaining the needle in the point for 30 minutes to maintain and prolong the effect after obtaining needling sensation,once a day. 10 days are one course of treatment. the methods of secondary acupuncture point: acupuncture with 30 size acicula,With conventional acupuncture and moxibustion methods,Once a day.Zusanli 1.0-1.5 inch into the piercing,quickly re-enforcing by twisting and twirling ,Mainly to supplement law,make local part feel sour-swollen, Emission to the lower extremity numbness better sense pin,When Zusanli left needle execute temperature acupuncture moxibustion therapy,moxibustion stick burning every 10-15min ,continuous operation on three times moxibustion. Pricking bloodletting Erjian,Dadun with uniform size three edged needle,the limitation is 10-20 drops erery acupoint. Once two days, 5 times are one course of treatment.Control group: prospective country name drugs, oral Xiaoyaowan, Once one pill(9 gram),a day twice. Treatment time 10 days are one course of treatment, not more than three courses of treatment (30 days), the principle of the trial period out of the impact of drug-related clinical efficacy. We observe their clinical hierarchical scale before and after treatment and judge their Prognoses by the CFS standard of liver depression and spleen deficiency、FS-14、FAI、SAS、SDS. we compare the two groups by the two groups before and after treatment in patients with integrals of comparison.Result:The overall efficacy of acupuncture moxibustion Beishu acupoint and pricking bloodletting therapy group was superior to the drug control group. The clinical total validity rate of treatment group is 93.3%,while the control group is 86.7%,by rank-sun test, efficacy of the two groups was significant difference (P<0.01).Conclusion : acupuncture moxibustion Beishu acupoint and pricking bloodletting therapy of the liver depression and spleen deficiency chronic fatigue syndrome efficacy is significant.更多还原